HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Library & Cultural Arts; 2023-09-0707-27-2023 7/27/23
CORODATA 9/7/2023
X
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RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING DEPARTMENT: REQUESTER: ~1'Y\£}-.. ~.QI(~-\\-
DESTRUCTION APPROVALS:
We certify that the records listed below have been retained for the scheduled retention period, required audits have been
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
BOX NO. RECORDS DESCRIPTION
\
\
\
\
DATE
DATED RRS NO.
'"LOO°\ ~w ,~s
Z..OOlo tw \ OS
CITY ATTORNEY DATE
RRS
PERIOD
TAB BARCODE
(if applicable)
\
\
~ \QS -+------~r--+------~
C,L>J I 0~
*If more spaces are needed, click in the last box in right hand corner of table and hit "tab". This will create more fields in the table.
To be filled out once records have i;Jeen destroyed.
RECORD DESTRUCTION COMPLETED BY: __________ _ DATE: _____ _
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
TAB BARCODES DELETED BY: DATE: -----------------------
This form documents the destruction af City records in accordance with the City of Carlsbad Records Management Program.
('Cityof
Carlsbad Revised: 2021
Page /1
07-27-2023 7/27/23
CORODATA 9/7/2023X
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RECORDS DESTRUCTION AUTHORIZAT IO N FOR M
DATE: ,;sL-~\u 21 ,, 2oJ..-~
REQUESTING DEPARTMENT: _....,,._,,o<..,v "'-'/K'-=\---=c......+---"-----REQUESTER: M' C>YI.~ t:.-v'V(QJ +-
-----------
DESTRUCTION APPROVALS:
We certify that the records listed below have been retained for the scheduled retention period, required audits have been
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO.
L
t.,
1...-
'2..
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: __________ _
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
TAB BARCODES DELETED BY: _____________ _
CITY ATTORNEY DATE
RRS
PERIOD
TAB BARCODE
(if applicable)
DATE: _____ _
DATE: _____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
{°City of
Carlsbad Revised: 2021
Page /1
07-27-2023 7/27/23
CORODATA 9/7/2023
X
-- --
RECORDS DESTRUCTION A UTHOR IZATIO N FOR M
DATE: ---'~',J--=µJ.,,,_,___,JA-2---'-,I /'-=-2JJ-=------Z_2_
REQUESTING DEPARTMENT: '-..J_e.l!s:._ REQUESTER: 'h'ovt°'-~V0(JL'-\t-
DESTRUCTION APPROVALS:
We certify that the records listed below have been retained for the scheduled retention period, required audits have been
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
DATE RECORDS MANAGEMENT DATE CITY ATTORNEY DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
~ A.~~ ~V\ \)~ \LQ '-) 2...001 -:z.o \-:; A9.--oc s ' tJ (~ I
J-:, r'l'\Y( D?OMt\.CI ,Aro ()JD..~1~ 'I (l..2,W-\-\1 C'.l.0\ \S (l~ loi 1~ w y\_0,Ut ,d
' _J "
*If more spaces are needed, click in the last box in right hand corner of table and hit "tab". This will create more fields in the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: __________ _ DATE: _____ _
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
TAB BARCODES DELETED BY: ______________ _ DATE: _____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
(°Cityof
Carlsbad Revised: 2021
Page /1
07-27-2023 7/27/23
CORODATA 9/7/2023
X
-- --
RECORDS DESTRUCTION A UTHOR IZATION FORM
DATE: :::S\.A..\u p\ ,2Q~ 7::J
REQuEsT1NG DEPARTMENT: ~LL~~A __ u __ 7
____ REQUESTER: ~rue-1)1 u .1,-\\-:-
DESTRUCTION APPROVALS:
We certify that the records listed below have been retained for the scheduled retention period, required audits have been
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO.
CITY ATTORNEY
RRS
PERIOD
DATE
TAB BARCODE
(if applicable)
*If more spaces are needed, click in the last box in right hand earner of table and hit "tab". This will create mare fields in the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: __________ _ DATE: -------
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
TAB BARCODES DELETED BY: DATE: ------------------------
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
('Cityof
Carlsbad Revised: 2021
Page /1
07-27-2023 7/27/23
CORODATA 9/7/2023
X
-- --
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING DEPARTMENT:
'J Ll \ % 1., \ ! '1,1) 1.,:,
t .,c Ac REQUESTER: -~---'-------· 'Olt\-"'-"----"~!!,1-""---t-......,.,✓,c...x>J---=QX~.Q,'----'\\-'--'--------
DESTRUCTION APPROVALS:
We certify that the records listed below have been retained for the scheduled retention period, required audits have been
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
BOX NO. RECORDS DESCRIPTION DATED
s
cs
'S
DATE
RRS NO.
CITY ATTORNEY
RRS
PERIOD
DATE
TAB BARCODE
(if applicable)
*If more spaces are needed, click in the last box in right hand corner of table and hit "tab". This will create more fields in the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: DATE: ------------------
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
TAB BARCODES DELETED BY: DATE: -----------------------
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
{°Cityof
Carlsbad Revised: 2021
Page /1
Account #(s)SD012455
Certificate #102710
Date Issued Tuesday, September 12, 2023
Service Locations 5815 EL CAMINO REAL
Date Range of Service Sep-07-2023 thru Sep-07-2023
Work Ticket(s)1197252
Quantity/Item 50 -50 Boxes for Destruction (standard)
* Nothing in this certificate shall be deemed to modify the terms of the parties’ Service Agreement(s) or Work Ticket(s).
CERTIFICATE OF DESTRUCTION & RECYCLING
This Certificate is presented to: CITY OF CARLSBAD - RECORDS MANAGEMENT DIVISION
Per the express request of Client, Corodata has received the Material referred to below and has/will destroy and then
recycle said Material in accordance with its standard procedures. As the parties have agreed, Corodata will not
inventory, record or track any information contained within or related to the Material.
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